Experts urge Medicaid reform to help mentally disabled

Expanding Medicaid to cover an estimated 500,000 Michigan residents without medical coverage can provide mental health care for thousands who without treatment could end up homeless, receiving expensive emergency rooms care or in prison, mental health experts say.

"It is sensible public policy to tap federal funds already set aside to expand preventive and life-saving health care under Medicaid," said Mike Vizena, executive director, Michigan Association of Community Mental Health Boards.

Expansion represents the best single opportunity to improve access to behavioral health-care services for Michigan's citizens most in need, he added.

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Paul Tarr, a legislative liaison for the Department of Community Health, agreed.

"It is my belief Medicaid reform will definitely help people with mental and physical disabilities," said Tarr.

Cuts to general fund support for mental health and substance use disorder services during the past decade "have resulted in a lack of access, reduction of services and creation of waiting lists for persons without Medicaid," Vizena said.

As a result, he said persons with emerging mental health and substance use disorders are not seen for care and end up in emergency room and hospitals "where their cost of care is 20 times greater" than if they had Medicaid coverage.

"Far too often these citizens wind up in criminal justice proceedings, or, in some cases, become homeless places where they do not belong and where they will not receive the care they need," he said.

Last month, a House subcommittee removed Gov. Snyder's proposed Medicaid expansion from its budget and in mid-April a Senate subcommittee did the same. The bills are SB198 and HB4213. Lawmakers in the state House and Senate are facing a June 1 self-imposed deadline to finish the state budget.

Efforts are under way by Michigan hospitals, mental health care providers, physicians, the Detroit Regional Chamber, the Small Business Association of Michigan and the Michigan Business and Professional Association to lobby Republicans who oppose Medicaid expansion to change their minds.

Studies have shown Michigan could save $1 billion in healthcare health care expenditures if it expands Medicaid to people with incomes up to 138 percent of the federal poverty level.

Michigan could receive $2 billion in federal funds during the next decade to finance those who become eligible for Medicaid such as the mentally ill. Snyder has said expanding Medicaid also will help some businesses with 50 provide coverage for workers under the Patient Protection and Affordable Care Act.

"The Michigan House of Representatives has supported this but the Senate, at this time, is worried about the federal government going to the extreme as far as its authority to cover costs of Medicaid reform," Tarr said.

Cuts to general fund support for mental health and substance use disorder services during the past decade have resulted in a lack of access, reduction of services and creation of waiting lists for a person without private insurance or Medicaid, he noted.

"In time, I think Michigan will reform Medicaid," Tarr said. "I support Medicaid reform and the Senate needs time to let it seep like a good cup of tea."

Last month, a House subcommittee removed Snyder's proposed Medicaid expansion from its budget and in mid-April a Senate subcommittee did the same. The bills are SB198 and HB4213.

Vizena also said expanding Medicaid would:

-- Help local community hospitals. "If the Michigan Legislature does not support Medicaid expansion, lawmakers jeopardize the financial stability of local hospitals across the state."

-- Require the federal government to cover the full cost of expansion through 2016, before gradually reducing funding to 90 percent by 2020.

-- Protect more than 300,000 of Michigan's most vulnerable residents in the next year alone; decrease the rate of emergency room visits that drive up health care costs for everyone and save the state millions a year in state spending.